Cohen, H, Neumann, L, Kotler, M et al. · The Israel Medical Association journal : IMAJ · 2001
This review examines how the autonomic nervous system—the part of your nervous system that controls heart rate, breathing, and digestion automatically—may not work properly in fibromyalgia and related conditions like ME/CFS and irritable bowel syndrome. Researchers found evidence that this system dysfunction could have important health consequences, including increased risk of heart problems. However, studies on this topic have produced mixed and sometimes contradictory results.
This review is important because it consolidates evidence that ME/CFS and related conditions involve measurable abnormalities in autonomic nervous system function, which could explain symptoms like abnormal heart rate responses and exercise intolerance. Understanding ANS dysfunction may lead to better diagnostic tools and treatments. It also raises awareness that patients with these conditions may face increased cardiovascular risk, warranting appropriate monitoring.
This review does not prove that autonomic dysfunction causes fibromyalgia or ME/CFS, nor does it establish the direction of causality. The contradictory results reported across studies mean that the consistency and specificity of ANS abnormalities remain unclear. The review does not provide definitive recommendations for clinical practice or demonstrate that treating ANS dysfunction will improve patient outcomes.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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